Surgical instrument



Nov. 9 1926. 1,606,497

A.A.R BERGER SURGICAL; INSTRUMENT Filed August 12, 1925 2 Sheets-Sheet 1lNVENTORj" ATTORNEY.

. Nov. 9 1926.

.A. A. R. BERGER SURGICAL INSTRUMENT Fi1ed.August 12 1925 '2Sheets-Sheet 2 INVEilTOR ATTORNEY v. .s 9w

Patented Nov. 9, 1926.

tum- S ar ALFRED AaR. BERGER, F BROOKLYN, NEW YORK.

suns-roar, INSTRUMENT.

, Application filed August 12, 1s25. Serial No. 49,707.

In the accompanying drawings I illus-.

trate a'practical embodiment of the essential i'eaturesof my inventionin a surgical de vice of the character designated, although l'do notlimit myself to the identical'lform, construction, andarrangement' ofcomponentparts and appurtenances shown herein by way ofex'emplilication, since changes may be madein'mi'nor details, andequivalent mechanical expedients resorted to with like results, andwithout departing from the spirit and intent ot'my invention in thisrespect.

With this understanding Fig. 1, represents a side elevation of myimproved surgical implement, as adapted for use h s snaring operation,socalled;

i Fig. 2,is a top view of the device as 35- shown in Fig. 1; I V

Fig. 3, is a side elevation in part of the arrangement shownin Figs. 1and2, only withthe latch eccentricretracted to release the ratchet bar;I

V Fig. 4,193. central longitudinal sectional elevation taken I uponplane'ioi line li,

Fig. 2;

' Fig. 5, is a partial side elevation similar to Fig. 1, showing theoperative parts in retracted co-relationship';

Fig; 6, is, a transverse section, upon a larger scale, taken upon planeof line 6 -6, Fig. 4.

j The handle H, oi? my new surgical instrument is formed integral with aforward bracket extension H, on which the opera-- t'ive-parts aremounted; Said'handl'e proper H, is also" formed wit-h a'rigid thumb resth, and a rigid straddle rest h, the latter for fitting in the crotchbet-ween the thumb and palm of the hand of the manipulator.

Pivotally attached tothe forward end of the bracket extension" H, isalongitudinal guide tube G, rectangular in cross'se'ction, and formedwith integral bearing lugs' g, 9,

through which the fulcrum screw-f, "extends as twell as through saidbracket extension H as shown more the drawings.

Integral with the rear portion of the particularly in Fig. of,

bracket extension H, are upright side lugs if, if, forming bearings foranother fulcrum screw f, on which the clamp-eccentric'E, is mounted,said clamp-eccentric. E, being formed with a handle 6, by'means of whichthe eccentric may be applied 'to or raised from the guide tube G, uponoccasion. A spring k countersunk in the upper fside of the bracketextension H, bears against the under side or theguide' tube} G, andtends constantly to hold the rear portion thereof against the eccentricE, as shown more particularly" in Fig. 4c, of the drawings;

. Slidably "mounted in the fguide' tube G, is a longitudinalratchet'ba'r'R, formed on its under side with a series of ratchet teeth7", r, extending substantially the whole length thereof, as also shownmore particularly'in said Fig. 4, of the drawings; a detent spring 1 2also countersunk in the upper side of the bracket extension H, engagingwith said ratchet teeth 1", r, and preventing forward movement of thesaid ratchet bar'R, when the guide tube G, isclamped to the bracketextension H, by means of the eccentric E, asv in Figs. 1, 3, 4 and 5, ofthe drawings;

Integral with and'constituting practically a prolongation otthe ratchet}bar R, is the snare or needle rod R, extending into and through thesupplementary guide tube G, which is"rigidly attached to and "forms acontinuation of the main or ratchet bar guide tube G, the outerextremity of said needle or snare rod B, being formed with eye holes 1",r, forthe threading and attachment of the snare wire 8, in a manner wellknown in the prior state of the art.

The inner or rear extremity of the ratchet bar R, is formed with afinger ring 9", to facilitate preliminary adjustment thereof, and alsoto afford means whereby both hands of the manipulator may be utilized ifnecessary in effecting successful operation in case of exceptionalresistance to severance of the anatomical part to be severed andremoved. The pawl P, for engagement with the teeth 7, r, of the ratchetbar R, is pivotally connected with the finger lever L, which isfulcrumed at Z, to the under side of the bracket extension H, and aspring 29, attached to the handle H, tends constantly to hold theotherwise free end of the pawl P, in engagement with said ratchet teeth1", r, as shown in Figs. 4L and 5, of the drawings. A leaf spring 7Lattached at its lower extremity to the handle H, contacts and interlockswith a corresponding spring Z, attached, to the finger lever L, the twosaid springs, acting in conjunction, tending constantly to thrust andhold said lever L, into its forward position and against the shoulder h,on the bracket extension H, as shown m Fig. 4, of the drawings.

When the eccentric E, is turned upward,

as in Fig. 3, the spring 7L tilts the guide tube G, on its fulcrum Z,sufi'iciently to raise the rear of the ratchet rack It, and its teetha", 1", out of contactual engagement with the pawl P, and detent h asindicated in Fig. 3, provided the finger lever L, is in normal forwardposition as in Figs. 1 and 4:, so that the ratchet rod R, and snare rodB, may be forwarded and adjusted longitudinally within and through theguide tubes G, G, by means of the finger ring 1*, on the rear end of theratchet rod It, according to requirements. The turning of the eccentricE, back to normal position as in Figs. 1, 4E and 5, re-establishesoperative engagement of the ratchet teeth 7", 1', with the said pawl P,and detent spring h so that when the finger lever L, is drawn toward thehandle H, the ratchet bar. It, and its snare rod R, will be retractedmore or less according to the extent of movement imparted to said fingerlever L. Thus, in the preliminary stages of an operation, and until thesnare s, is drawn taut, a full stroke of the finger lever L, may beresorted to, retracting the ratchet bar R, and snare rod It, acorresponding number of teeth, after which the finger lever may be somanipulated as to move the ratchet bar R, and snare rod B, only to theextent of one, two or more teeth as required, it being understood thatthe finger lever L, when released, is returned automatically, by meansof the springs Z, h to its normal forward position against the restshoulder h, on the bracket extension-G.

When fully retracted, or nearly so, the

movement, so that the retraction of said ratchet bar It, and snare rodB, may be effected progressively in a plurality of pulls exerted throughthe medium of said finger lever L.

This tendency of the finger lever L, to recede automatically from thehandle H, when released or permitted by the lingers of the operator isan important factor in attaining rapid and efiective retraction of, theratchet bar It, snare rod R, and snare s, and this is accomplishedwithout loss of control by the manipulator, so that satisfactory resultsmay be attained with the minimum degree of exertion and least possiblediscomfort to the patient under treatment under ordinary circumstancesand conditions of use. F urthermore this advantage may be supplementedin case of necessity, if extraordinary resistance is encountered, by theutilization of the finger ring 1, on the rear end of the ratchet rod R,as a means of applying additional pull and power to the snare 8, throughthe medium of the otherwise disengaged hand of the operator.

Equivalent clamping means may be substituted in lieu of the eccentric E;and any suitable elastic resilient expansive means may be interposedbetween the handle H, and the finger lever L, in lieu of the springs Z,and k What I claim as my invention and desire to secure by LettersPatent, is:

1. In a surgical instrument of the character designated, the combinationof a handle formed with a bracket extension, guide tubing pivotallymounted'on said bracket extension, clamping means mounted on said handleand adapted to bind the guide tubing to said bracket extension, elasticresilient means arranged to press said pivotally mounted guide tubingagainst said clamping means, a ratchet bar and snare rod mounted in saidguide tubing, a finger lever fulcrumed on said handle, and a spring pawlpivotally connected with said finger lever and engageable with the teethon said ratchet bar, substantially in the manner and for the purpose setforth. 7

2. In a surgical instrument of the character designated, the combinationof a handle formed with a bracket extension, guide tubing pivotallymounted on said bracket extension, clamping means mounted on said handleand adapted to bind said pivotally mounted guide tubing to said bracketextension, elastic resilient ineans arranged to press said pivotallymounted guide tubing against said clamping means, a ratchet bar andsnare rod mounted in said guide tubing, a spring cletent on the handleengageable With the teeth of the ratchet bar, a linger lever l'ulcruinedon said handle, a spring pawl pivotally connected with said finger leverand engageable with the teeth of said ratchet bar, and elastic resilientmeans interposed between said finger lever and the handle and tending tohold said finger lever in retracted position as related to the handle,for the purpose and substantially in the manner set forth.

ALFRED A. n. BERGER.

